10 research outputs found
Hepatic Trauma: A 21-year Experience [trauma Hepático: Uma Experiência De 21 Anos]
No full textObjective: To evaluate the epidemiological aspects, behavior, morbidity and treatment outcomes for liver trauma. Methods: We conducted a retrospective study of patients over 13 years of age admitted to a university hospital from 1990 to 2010, submitted to surgery or nonoperative management (NOM). Results: 748 patients were admitted with liver trauma. The most common mechanism of injury was penetrating trauma (461 cases, 61.6%), blunt trauma occurring in 287 patients (38.4%). According to the degree of liver injury (AAST-OIS) in blunt trauma we predominantly observed Grades I and II and in penetrating trauma, Grade III. NOM was performed in 25.7% of patients with blunt injury. As for surgical procedures, suturing was performed more frequently (41.2%). The liver-related morbidity was 16.7%. The survival rate for patients with liver trauma was 73.5% for blunt and 84.2% for penetrating trauma. Mortality in complex trauma was 45.9%. Conclusion: trauma remains more common in younger populations and in males. There was a reduction of penetrating liver trauma. NOM proved safe and effective, and often has been used to treat patients with penetrating liver trauma. Morbidity was high and mortality was higher in victims of blunt trauma and complex liver injuries.404318322Talving, P., Beckman, M., Häggmark, T., Iselius, L., Epidemiology of liver injuries (2003) Scand J Surg., 92 (3), pp. 192-194Diorio, A.C., Fraga, G.P., Dutra Jr., I., Joaquim, J.L., Mantovani, M., Predictive factors of morbidity and mortality in hepatic trauma (2008) Rev Col Bras Cir., 35 (6), pp. 397-405Smaniotto, B., von Bahten, L.C., Nogueira Filho, D.C., Tano, A.L., Thomaz Júnior, L., Fayad, O., Hepatic trauma: Analysis of the treatment with intrahepatic balloon in a university hospital of Curitiba (2009) Rev Col Bras Cir., 36 (3), pp. 217-222Croce, M.A., Fabian, T.C., Menke, P.G., Waddle-Smith, L., Minard, G., Kudsk, K.A., Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. Results of a prospective trial (1995) Ann Surg., 221 (6), pp. 744-753Sriussadaporn, S., Pak-art, R., Tharavej, C., Sirichindakul, B., Chiamananthapong, S., A multidisciplinary approach in the management of hepatic injuries (2002) Injury., 33 (4), pp. 309-315Champion, H.R., Sacco, W.J., Copes, W.S., Gann, D.S., Gennarelli, T.A., Flanagan, M.E., A revision of the Trauma Score (1989) J Trauma., 29 (5), pp. 623-629Baker, S.P., O'Neill, B., Haddon Jr., W., Long, W.B., The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care (1974) J Trauma., 14 (3), pp. 187-196Boyd, C.R., Tolson, M.A., Copes, W.S., Evaluating trauma care: The TRISS method. Trauma Score and the Injury Severity Score (1987) J Trauma., 27 (4), pp. 370-378Moore, E.E., Cogbill, T.H., Jurkovich, G.J., Shackford, S.R., Malangoni, M.A., Champion, H.R., Organ injury scaling: Spleen and liver (1994 revision) (1995) J Trauma., 38 (3), pp. 323-324Stalhschmidt, C.M., Formighieri, B., Marcon, D.M., Takejima, A.L., Soares, L.G.S., Hepatic trauma: Five years of epidemiology in an emergency service (2008) Rev Col Bras Cir., 35 (4), pp. 225-228Malhotra, A.K., Fabian, T.C., Croce, M.A., Gavin, T.J., Kudsk, K.A., Minard, G., Blunt hepatic injury: A paradigm shift from operative to nonoperative management in the 1990s (2000) Ann Surg., 231 (6), pp. 804-813Matthes, G., Stengel, D., Seifert, J., Rademacher, G., Mutze, S., Ekkernkamp, A., Blunt liver injuries in polytrauma: Results from a cohort study with the regular use of whole-body helical computed tomography (2003) World J Surg., 27 (10), pp. 1124-1130Krige, J.E., Bornman, P.C., Terblanche, J., Liver trauma in 446 patients (1997) S Afr J Surg., 35 (1), pp. 10-15Scollay, J.M., Beard, D., Smith, R., McKeown, D., Garden, O.J., Parks, R., Eleven years of liver trauma: The Scottish experience (2005) World J Surg., 29 (6), pp. 744-749Pachter, H.L., Knudson, M.M., Esrig, B., Ross, S., Hoyt, D., Cogbill, T., Status of nonoperative management of blunt hepatic injuries in 1995: A multicenter experience with 404 patients (1996) J Trauma., 40 (1), pp. 31-38Asensio, J.A., Demetriades, D., Chahwan, S., Gomez, H., Hanpeter, D., Velmahos, G., Approach to the management of complex hepatic injuries (2000) J Trauma, 48 (1), pp. 66-69Kozar, R.A., Moore, J.B., Niles, S.E., Holcomb, J.B., Moore, E.E., Cothren, C.C., Complications of nonoperative management of high-grade blunt hepatic injuries (2005) J Trauma., 59 (5), pp. 1066-1071Sikhondze, W.L., Madiba, T.E., Naidoo, N.M., Muckart, D.J., Predictors of outcome in patients requiring surgery for liver trauma (2007) Injury., 38 (1), pp. 65-70Fraga, G.P., Zago, T.M., Pereira, B.M., Calderan, T.R., Silveira, H.J., Use of Sengstaken-Blakemore intrahepatic balloon: An alternative for liver-penetrating injuries (2012) World J Surg., 36 (9), pp. 2119-2124Meredith, J.W., Young, J.S., Bowling, J., Roboussin, D., Nonoperative management of blunt hepatic trauma: The exception or the rule? (1994) J Trauma., 36 (4), pp. 529-534Bynoe, R.P., Bell, R.M., Miles, W.S., Close, T.P., Ross, M.A., Fine, J.G., Complications of nonoperative management of blunt hepatic injuries (1992) J Trauma., 32 (3), pp. 308-314Sherman, H.F., Savage, B.A., Jones, L.M., Barrette, R.R., Latenser, B.A., Varcelotti, J.R., Nonoperative management of blunt hepatic injuries: Safe at any grade? (1994) J Trauma., 37 (4), pp. 616-621Coimbra, R., Hoyt, D.B., Engelhart, S., Fortlage, D., Nonoperative management reduces the overall mortality of grades 3 and 4 blunt liver injuries (2006) Int Surg., 91 (5), pp. 251-257Norrman, G., Tingstedt, B., Ekelund, M., Andersson, R., Non-operative management of blunt liver trauma: Feasible and safe also in centres with a low trauma incidence (2009) HPB., 11 (1), pp. 50-56Zago, T.M., Pereira, B.M., Calderan, T.R., Hirano, E.S., Rizoli, S., Fraga, G.P., Blunt hepatic trauma: Comparison between surgical and nonoperative treatment (2012) Rev Col Bras Cir., 39 (4), pp. 307-313Zago, T.M., Tavares Pereira, B.M., Araujo Calderan, T.R., Godinho, M., Nascimento, B., Fraga, G.P., Nonoperative management for patients with grade IV blunt hepatic trauma (2012) World J Emerg Surg., 7 (SUPPL. 1), pp. S8Pereira, B.M., Non-operative management of hepatic trauma and the interventional radiology: An update review (2012) Indian J Surg., , [on line]Carrasco, C.E., Godinho, M., de Azevedo Barros Berti, M., Rizoli, S., Fraga, G.P., Fatal motorcycle crashes: A serious public health problem in Brazil (2012) World J Emerg Surg., 7 (SUPPL. 1), pp. S
[[alternative]]A Case Study on the Demand of the Employee Career Development within the Process of Public Enterprises Civilization： the Bureau of Taiwan Railway Administration
No full text[[abstract]]The purpose of this study is to know the career developing demand of the workers in the Bureau of Taiwan Railway Administration（T.R.A.）when this traditional public enterprise will be civilized and then give some suggestions to them by the research method of surveying. We hope to realize and answer that following questions:
1. whether the workers understand and agree the relative issues of the civilization of T.R.A？
2. The satisfaction degree of working environments now and the expectation for the future.
3. What kind of individual career programming will be performed when they face the fact of the civilization？
4. What kind of career developing assistant policy and methods of organization and labor union are needed by staff？
5. Are there any significant difference answers for the first to the fourth question between persons of different sex, monthly income, age and educational degree etc.？
The questionnaires were sent to individuals in the different divisions in T.R.A. by the ratio of person number of every department. Using the program package of SPSS as data processing and analysis tool and by the statistical method of describe statistics, T test and ANOVA method（advanced post hoc different test was performed by Scheffe method）, we have got the conclusions which can be summarized as following：
1. Most of the workers in T.R.A. still don’t understand and disagree its civilization relative policies now. And their major five sources of information about this issue are friends and colleagues, the published magazine of their labor union, labor union, newspapers and the data from the organization.
2. Main parts of staff feel satisfy for the working environments and conditions now and think it will get worse if the organization have been civilized.
3. People with different property will make different decisions in this situation such as turnoff, applying for retire in advance or continuing original job. But the major tendency of the workers for their own career planning seems to wish still staying in T.R.A. again.
4. People with different property hope their organization and labor union can supply not the same assistances such as the training and introduction of other jobs for whom planning to turnover, the secondary specialized ability training for persons might have to change position with the organization reengineering etc..
And then this study makes some suggestions to T.R.A., workers, labor union, the relative organizations and the feasible researches for the future etc..
HALO: stimulating pro-environmental disposal behaviour
No full textThis thesis presents the conceptual design process of a new intervention to stimulate pro-environmental disposal behaviour. Littering is a growing problem in the world. Research shows that the brand which is found most between the litter in the Netherlands is Red Bull. Although many interventions have been applied to try to change behaviour of litterers in the Netherlands, the littering behaviour of the Red Bull consumer remains a problem. This thesis concentrates on the question how the Red Bull consumer can be stimulated to dispose their can in an environmental friendly way. Different studies have been conducted within a cultural and social design approach. This is done in order to identify the different elements that influence the consumption and disposal of the Red Bull energy drink within the Dutch culture. From the analysis it appeared that (at the moment of purchasing a Red Bull can) as good as every Dutch consumer has the intention to dispose the can in an environmental friendly way, but the problem is that they do not always act according this intention. From these insights the aim emerged to strengthen the attitude of the Red Bull consumer towards the social norm of appropriate disposal behaviour. The final proposed concept Halo motivates users to behave according to their intended behaviour. At the moment of purchase the Red Bull consumer is offered to choose between the Halo edition; a limited edition with a golden wrap on top of the can, and the original edition. By choosing the Halo edition he or she promises to himself to dispose the empty can in an environmental friendly way. In this design the golden wrap is the mark that represents the good behaviour. The golden wrap not only reminds the user during the consumption to keep his promise. By choosing a remarkable packaging this person is also able to propagate this intended behaviour to his social environment. To communicate the concept and explain the function of the new design, a movie is presented on the vending machine or fridge, The understandability of the concept has been tested among different levels of education, who positively responded to both the new appearance and the idea behind the concept. Finally, the feedback from users and experts are used to evaluate and reflect on the introduced concept. Further recommendations are made to optimize the user experience of the initiated concept.Industrial Design EngineeringIndustrial Desig
Initial Experience At A University Teaching Hospital From Using Telemedicine To Promote Education Through Video Conferencing [experiência Inicial De Um Hospital Universitário Utilizando A Telemedicina Na Promoção De Educação Através De Vídeo-conferências]
No full textCONTEXT AND OBJECTIVE: Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. DESIGN AND SETTING: Retrospective study at Universidade Estadual de Campinas. METHODS: Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. RESULTS: A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (± 4.3) teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (± 2.7), or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22% and 21% of the total calls. CONCLUSION: Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country, and to other reference centers abroad. This virtual proximity has enabled discussion of international training with students and residents, to increase their overall knowledge and improve their education within this institution.13013236Bashshur, R.L., On the definition and evaluation of telemedicine (1995) Telemed J, 1 (1), pp. 19-30Alverson, D.C., Edison, K., Flournoy, L., Telehealth tools for public health, emergency, or disaster preparedness and response: A summary report (2010) Telemed J E Health, 16 (1), pp. 112-114Ereso, A.Q., Garcia, P., Tseng, E., Live transference of surgical subspecialty skills using telerobotic proctoring to remote general surgeons (2010) J Am Coll Surg, 211 (3), pp. 400-411Mauer, U.M., Kunz, U., Management of neurotrauma by surgeons and orthopedists in a military operational setting (2010) Neurosurg Focus, 28 (5), pp. E10Huang, C.M., Chan, E., Hyder, A.A., Web 2.0 and internet social networking: A new tool for disaster management? --lessons from Taiwan (2010) BMC Med Inform Decis Mak, 10, p. 57Blanche, P.A., Bablumian, A., Voorakaranam, R., Holographic three-dimensional telepresence using large-area photorefractive polymer (2010) Nature, 468 (7320), pp. 80-83Jabbour, P., Gonzalez, L.F., Tjoumakaris, S., Randazzo, C., Rosenwasser, R., Stroke in the robotic era (2010) World Neurosurg, 73 (6), pp. 603-604Latifi, R., Stanonik, M.L., Merrell, R.C., Weinstein, R.S., Telemedicine in extreme conditions: Supporting the Martin Strel Amazon Swim Expedition (2009) Telemed J E Health, 15 (1), pp. 93-100Landers, S.H., Why health care is going home (2010) N Engl J Med, 363 (18), pp. 1690-1691Hede, K., Teleoncology gaining acceptance with physicians, patients (2010) J Natl Cancer Inst, 102 (20), pp. 1531-1533García jordá, E., Telemedicine: Shortening distances (2010) Clin Transl Oncol, 12 (10), pp. 650-651Latifi, R., Telepresence and telemedicine in trauma and emergency (2008) Stud Health Technol Inform, 131, pp. 275-280Hays, R.B., Peterson, L., Options in education for advanced trainees in isolated general practice (1996) Aust Fam Physician, 25 (3), pp. 362-366Ekeland, A.G., Bowes, A., Flottorp, S., Effectiveness of telemedicine: A systematic review of reviews (2010) Int J Med Inform, 79 (11), pp. 736-771Scuffham, P., Systematic review of cost effectiveness in telemedicine. Quality of cost effectiveness studies in systematic reviews is problematic (2002) BMJ, 325 (7364), p. 598. , author reply 598Rezende, E.J.C., Melo, M.C.B., Tavares, E.C., Santos, A.F., Souza, C., Ethics and eHealth: Reflections for a safe practice (2010) Rev Panam Salud Pública = Pan Am J Public Health, 28 (1), pp. 58-65Motoi, K., Ogawa, M., Ueno, H., A fully automated health-care monitoring at home without attachment of any biological sensors and its clinical evaluation (2009) Conf Proc IEEE Eng Med Biol Soc, 2009, pp. 4323-4326Azpiroz-Leehan, J., Martínez, L.F., Cadena, M.M., Imaging Facilities for Basic Medical Units: A Case in the State of Guerrero, Mexico (2010) J Digit Imaging, , Epub ahead of printKailas, A., Chong, C.C., Watanabe, F., From mobile phones to personal wellness dashboards (2010) IEEE Pulse, 1 (1), pp. 57-63Eron, L., Telemedicine: The future of outpatient therapy? (2010) Clin Infect Dis, 51 (SUPPL. 2), pp. S224-S230Nakajima, I., Japanese telemedical concept of ambulatory application (2011) J Med Syst, 35 (2), pp. 215-220Haidegger, T., Sándor, J., Benyó, Z., Surgery in space: The future of robotic telesurgery (2011) Surg Endosc, 25 (3), pp. 681-690Machado, F.S.N., Carvalho, M.A.P., Mataresi, A., Use of telemedicine technology as a strategy to promote health care of riverside communities in the Amazon: Experience with interdisciplinary work, integrating NHS guidelines (2010) Ciên Saúde Coletiva, 15 (1), pp. 247-254Latifi, R., Hadeed, G.J., Rhee, P., Initial experiences and outcomes of telepresence in the management of trauma and emergency surgical patients (2009) Am J Surg, 198 (6), pp. 905-910Bulik, R.J., Shokar, G.S., Integrating telemedicine instruction into the curriculum: Expanding student perspectives of the scope of clinical practice (2010) J Telemed Telecare, 16 (7), pp. 355-35
The Use Of Corticosteroid For The Prophylaxis Of Fat Embolism Syndrome In Patients With Long Bone Fracture [uso De Corticoide Na Profilaxia Para Síndrome De Embolia Gordurosa Em Pacientes Com Fratura De Osso Longo]
No full textThe "Evidence-based Telemedicine - Trauma & Acute Care Surgery" (EBT-TACS) Journal Club conducted a critical review of the literature and selected three recent studies on the use of corticosteroids for the prophylaxis of fat embolism syndrome (FES). The review focused on the potential role of corticosteroids administration to patients admitted to the intensive care unit (ICU) at risk of developing post-traumatic fat embolism. The first study was prospective and aimed at identifying reliable predictors, which could be detected early and were associated with the onset of fat embolism syndrome in trauma patients. The second manuscript was a literature review on the role of corticosteroids as a prophylactic measure for FES. The last manuscript was a meta-analysis on the potential for corticosteroids to prophylactically reduce the risk of fat embolism syndrome in patients with long bone fractures. The main conclusions and recommendations reached were that traumatized patients should be monitored with non-invasive pulse oximetry and lactate levels since these commonly-available tests may predict the development of FES, and the lack of evidence to recommend the use of steroids for the prophylaxis of this syndrome.405423426Gopinathan, N.R., Sen, R.K., Viswanathan, V.K., Aggarwal, A., Mallikarjun, H.C., Rajaram Manoharan, S.R., Early, reliable, utilitarian predictive factors for fat embolism syndrome in polytrauma patients (2013) Indian J Crit Care Med., 17 (1), pp. 38-42Sen, R.K., Tripathy, S.K., Krishnan, V., Role of corticosteroid as a prophylactic measure in fat embolism syndrome: A literature review (2012) Musculoskelet Surg., 96 (1), pp. 1-8Bederman, S.S., Bhandari, M., McKee, M.D., Schemitsch, E.H., Do corticosteroids reduce the risk of fat embolism syndrome in patients with long-bone fractures? A meta-analysis (2009) Can J Surg., 52 (5), pp. 386-393Moore, F.A., Haenel, J.B., Moore, E.E., Whitehill, T.A., Incommensurate oxygen consumption in response to maximal oxygen availability predicts postinjury multiple oxygen failure (1992) J Trauma., 33 (1), pp. 58-65. , discussion 65-7Kim, P.K., Deutschman, C.S., Inflammatory responses and mediators (2000) Surg Clin North Am., 80 (3), pp. 885-894Kallenbach, J., Lewis, M., Zaltzman, M., Feldman, C., Orford, A., Zwi, S., 'Low-dose' corticosteroid prophylaxis against fat embolism (1987) J Trauma., 27 (10), pp. 1173-1176Lindeque, B.G., Schoeman, H.S., Dommisse, G.F., Boeyens, M.C., Vlok, A.L., Fat embolism and the fat embolism syndrome. A double-blind therapeutic study (1987) J Bone Joint Surg Br., 69 (1), pp. 128-131Schonfeld, S.A., Ploysongsang, Y., DiLisio, R., Crissman, J.D., Miller, E., Hammerschmidt, D.E., Fat embolism prophylaxis with corticosteroids. A prospective study in high-risk patients (1983) Ann Intern Med., 99 (4), pp. 438-44
Blunt Hepatic Trauma: Comparison Between Surgical And Nonoperative Treatment [trauma Hepático Contuso: Comparação Entre O Tratamento Cirúrgico E O Não Operatório]
No full textObjective: The objective of this study is to examine the outcomes of blunt hepatic trauma, and compare surgical and nonsurgical treatment on patients admitted with hemodynamic stability and with no obvious indications of laparotomy. Methods: This is a retrospective study of cases admitted to a university teaching hospital between 2000 and 2010. In this period, 120 patients were admitted with blunt hepatic trauma. Sixty five patients (54.1%) were treated non-operatively and fifty five patients were operated upon. Patients who were to undergo surgical treatment were divided into two groups: (A) all those patients undergoing surgical treatment (55) and (B) those patients with no obvious indication for surgery (13). Results: Patients treated non-operatively had better physiological conditions on admission, had less severe injuries (except the grade of hepatic injury), received less blood components and had lower morbidity and mortality rates than patients operated upon (Group A). Patients operated upon, but with no obvious indications for surgery, had higher rates of complication and mortality than nonoperated patients. Conclusion: A non-operative approach results in lower complications, a lesser need for blood transfusions and a lower mortality rate.394307313Talving, P., Beckman, M., Häggmark, T., Iselius, L., Epidemiology of liver injuries (2003) Scand J Surg., 92 (3), pp. 192-194London, J.A., Parry, L., Galante, J., Battistella, F., Safety of early mobilization of patients with blunt solid organ injuries (2008) Arch Surg., 143 (10), pp. 972-976. , discussion 977Smaniotto, B., Bahten, L.C.V., Nogueira Filho, D.C., Tano, A.L., Thomaz Júnior, L., Fayad, O., Trauma hepático: Análisedo tratamento com balão intra-hepático em um hospital universitário de Curitiba (2009) Rev Col Bras Cir., 36 (3), pp. 217-222Stracieri, L.D., Scarpelini, S., Hepatic injury (2006) Acta Cir Bras., 21 (SUPPL. 1), pp. 85-88Velmahos, G.C., Toutouzas, K., Radin, R., Chan, L., Rhee, P., Tillou, A., High success with nonoperative management of blunt hepatic trauma: The liver is a sturdy organ (2003) Arch Surg., 138 (5), pp. 475-480. , discussion 480-1Malhotra, A.K., Fabian, T.C., Croce, M.A., Gavin, T.J., Kudsk, K.A., Minard, G., Blunt hepatic injury: A paradigm shift from operative to nonoperative management in the 1990s (2000) Ann Surg., 231 (6), pp. 804-813Mullinix, A.J., Foley, W.D., Multidetector computed tomography and blunt thoracoabdominal trauma (2004) J Comput Assist Tomogr., 28 (SUPPL. 1), pp. S20-S27Jacobs, D.G., Sarafin, J.L., Marx, J.A., Abdominal CT scanning for trauma: How low can we go? (2000) Injury., 31 (5), pp. 337-343Pachter, H.L., Knudson, M.M., Esrig, B., Ross, S., Hoyt, D., Cogbill, T., Status of nonoperative management of blunt hepatic injuries in 1995: A multicenter experience with 404 patients (1996) J Trauma., 40 (1), pp. 31-38Stein, D.M., Scalea, T.M., Nonoperative management of spleen and liver injuries (2006) J Intensive Care Med., 21 (5), pp. 296-304Coimbra, R., Hoyt, D.B., Engelhart, S., Fortlage, D., Nonoperative management reduces the overall mortality of grades 3 and 4 blunt liver injuries (2006) Int Surg., 91 (5), pp. 251-257Moore, E.E., Cogbill, T.H., Jurkovich, G.J., Shackford, S.R., Malangoni, M.A., Champion, H.R., Organ injury scaling: Spleen and liver (1994 revision) (1995) J Trauma., 38 (3), pp. 323-324Champion, H.R., Sacco, W.J., Copes, W.S., Gann, D.S., Gennarelli, T.A., Flanagan, M.E., A revision of the Trauma Score (1989) J Trauma., 29 (5), pp. 623-629Baker, S.P., O'Neill, B., Haddon Jr., W., Long, W.B., The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care (1974) J Trauma., 14 (3), pp. 187-196Civil, I.D., Schwab, C.W., The Abbreviated Injury Scale, 1985 revision: A condensed chart for clinical use (1988) J Trauma., 28 (1), pp. 87-90Borlase, B.C., Moore, E.E., Moore, F.A., The abdominal trauma index-a critical reassessment and validation (1990) J Trauma., 30 (11), pp. 1340-1344Schluter, P.J., Nathens, A., Neal, M.L., Goble, S., Cameron, C.M., Davey, T.M., Trauma and Injury Severity Score (TRISS) coefficients 2009 revision (2010) J Trauma., 68 (4), pp. 761-770Croce, M.A., Fabian, T.C., Menke, P.G., Waddle-Smith, L., Minard, G., Kudsk, K.A., Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. Results of a prospective trial (1995) Ann Surg., 221 (6), pp. 744-753. , discussion 753-5von Bahten, L.C., Nicoluzzi, J.E., Olandoski, M., Pantanali C.A.R, Silva, R.F.K.C., Trauma abdominal fechado: Análise dos pacientes vítimas de trauma hepático em um hospital universitário de Curitiba (2005) Rev Col Bras Cir., 32 (6), pp. 316-320Norrman, G., Tingstedt, B., Ekelund, M., Andersson, R., Non-operative management of blunt liver trauma: Feasible and safe also in centres with a low trauma incidence (2009) HPB., 11 (1), pp. 50-56Meredith, J.W., Young, J.S., Bowling, J., Roboussin, D., Nonoperative management of blunt hepatic trauma: The exception or the rule? (1994) J Trauma., 36 (4), pp. 529-534. , discussion 534-5Kozar, R.A., Moore, J.B., Niles, S.E., Holcomb, J.B., Moore, E.E., Cothren, C.C., Complications of nonoperative management of high-grade blunt hepatic injuries (2005) J Trauma., 59 (5), pp. 1066-1071Bynoe, R.P., Bell, R.M., Miles, W.S., Close, T.P., Ross, M.A., Fine, J.G., Complications of nonoperative management of blunt hepatic injuries (1992) J Trauma., 32 (3), pp. 308-314. , discussion 314-5Malhotra, A.K., Latifi, R., Fabian, T.C., Ivatury, R.R., Dhage, S., Bee, T.K., Multiplicity of solid organ injury: Influence on management and outcomes after blunt abdominal trauma (2003) J Trauma., 54 (5), pp. 925-929Sikhondze, W.L., Madiba, T.E., Naidoo, N.M., Muckart, D.J., Predictors of outcome in patients requiring surgery for liver trauma (2007) Injury., 38 (1), pp. 65-70Feliciano, D.V., Mattox, K.L., Jordan Jr., G.L., Burch, J.M., Bitondo, C.G., Cruse, P.A., Management of 1000 consecutive cases of hepatic trauma (1979-1984) (1986) Ann Surg., 204 (4), pp. 438-445Kozar, R.A., Moore, F.A., Cothren, C.C., Moore, E.E., Sena, M., Bulger, E.M., Risk factors for hepatic morbidity following nonoperative management: Multicenter study (2006) Arch Surg., 141 (5), pp. 451-458. , discussion 458-9Scollay, J.M., Beard, D., Smith, R., McKeown, D., Garden, O.J., Parks, R., Eleven years of liver trauma: The Scottish experience (2005) World J Surg., 29 (6), pp. 744-749Archer, L.P., Rogers, F.B., Shackford, S.R., Selective nonoperative management of liver and spleen injuries in neurologically impaired adult patients (1996) Arch Surg., 131 (3), pp. 309-315Shapiro, M.B., Nance, M.L., Schiller, H.J., Hoff, W.S., Kauder, D.R., Schwab, C.W., Nonoperative management of solid abdominal organ injuries from blunt trauma: Impact of neurologic impairment (2001) Am Surg., 67 (8), pp. 793-79
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Mrs William Shelbourne Is visiting her parents. Mr. and Mr» A
Kmm**na of Morgan Hill.
Twenty-six men will r*prea*nt
Stanford tomorrow In the Portola
track meet In San Kranclaco.
mam
The Stanford varsity will play tbe
barbarians tomorrow afternoon. The
aeeund Varsity will meet the Marinas
This space will be devoted to
CHIROPRACTIC
Watch it from day to day and learn what this NEW SCIENCE is doing for your Friends and Neighbors, and others,
CMS No •* Mrt. _____ llil tuStr-ad !..- Mi-fo i-in ■Hh Nervou, Skr*
H'j'li-1--. I min-J run an-] Coast-p*. ItfM
S*W took Spinal AJ -ait Mat*, oaaa am-iatth aad t>tal.v** toll ra\*al
Tldt-Ji'ilTJlMwiD-li^rmalllWit-w iu Umbc t*rt*rcs*Md ia mar nam mod aMkiai
lu vefilj Oil* tUlnmnt
If yon ata Miltering let n- thow VOL*.
t ..o*it!t*t*-'n and anal**—« fn--. oflli■■• bour* 9 a. m. to 3 p. m.
tl Ilryani -a ■■.-*■!. |***lo \\u,
E. R. Blanchard
CHIROPRACTOR.
Who Made Your Mattress?
If you could sleep better—
You could think cicarer
Your work would seem easier
You would be better natured
You would worry less and live longer
Then Buy a SEALY
It gives ioo per cent of comfort. We have a large assort
ment of
Mattresses, Pillows Quilts and
Blankets
Palo Alto Furniture Co.
asa University Avenue. PHONE ia.
PROFESSOR CROSS WILL
SPEAK AT WISCONSIN
D. J. WILLIAMS Classified Adv-rtiaemenu
Professor I. H Cross I* at *>re**-*nl
• • • In Chicago. Ha wlll lea** ahortly
Mi-i Acnes Holland of Hayward '■ tor th* .I'nlveraliy of Wlaconaln.
I* th« nuMt of Mr. and Mr* Frank : where h« will seak before th* claaa**
Kasson of I'rofeaaor Commons of that unl-
• • • „ ' verslty oa labor condition*. Whit*
Mrs. Chalmers A Graham and:in Wlaconstn Profesaor Cross wlll
daughter* are siiendln* the weekend I investigate th* Industrial accident
In -San Francisco seeing the sight* - board of that state.
of tbe Portola festival. —*
SpcciaJ Portola Train.
A special train wlll run from Pain
Alto to San Kranclaco without atop
this waning, leaving t)*r* at t.i.*..
according to Ag*nt Robertson of the
• • • j Southern Pacific. Thla will land
John f**alsworthy* "Justice" will! the oh-be-Joyf u Is right la tbe con-
as the basis of the sermon by n*v. fetti before 8 o'clock.
Roy H Campbell at the Congrega-1 -— -
tlonal Cburch on Sunday night. j A p,,-.„,„.«. Lov. UttUr Wr(tor.
{ In to* Anierl.au Maiatlne appears
Mr. and Mr* R. 8. Winn and son j under the tlcl* A Handy Man Wltb
Richard a|ient th* day in Han Fran- tile l**u" tbe i-onfi-aelnn of a man wbo
elaeo. where they went tn see the i*» ■ prufeealonal writer of loe* letters.
Pantda fewtlval parade. f after dluner *p**eb*r». otdtuary poetry.
m em *a j *"'■" •''"* tollo* 'til *"* """ "* the SIo-
' rie* tie tells annul writing loe* letters
tor a i-UHluiner:
\*Jt for Mi*. I'.Kier.
iti:.\i. i.vniK, i**.-.i R.iM'i.,
1-OANf-*.
'_•*•! I TliY-TMl) AlrtJUf
PAIXJ A-TI-O—MiN-lfTVAIaC.
PALO ALTO
9 4JS0—Choice lot In Seale Addition.
Better pick thla up It doesn't
happen every day.
FOR RENT.
' Por Rent—Furntahsd 4-room fist.
3;: Hamilton avenue. 10*!'-tf
Sunny four-room apartment wltb
bath and large porch: desirable location. Apply uSO University ave.
10-M-lm*
Mr. and Mrs. R H. McKatg spent
Wedneaday In San Franclaco, wher*
they went to nee the Portola
Pnife**n-r II. II Campbell o( the
Sianford botany department gave a
lecture yesterday afternoon tin hla
men* t:li> around the world
Tbe high achool ae<-ond leam
pla ythe "peanut league team
Stanfnrd this afternoon on
Stanford turf.
hr and Mr*.
tertalned a few
an Informal dance last nlgli
"One day lant fall a hand-tome young
man. mmh emt-arrasaed. appeared and
after MDM* he-dlutl in ■..:.*.■-,.-.! that be
bad ueu i- t.-il hla education and * *■<
cufTr-aiaiiidlna wtth a young wou-et-
* itii whom he wa* very much In love
Slit- wa* a < ■; i-m- graduate, and h« de
aired tu bar* In*. letter* a* well written
a* ber* were. ■*■• be wanted me to wrlie
HcCowen en* I th-jn, i advlned btm to wrtle almpl j
their friend* at j aud a* be talked, but be persisted. a'Dtl
at night at their 'twice a week he came. Informed ne
th*
Siimk)—Fine building lot la built-/
up section; wll] build for pur-,
chaser and take payment to
s—all monthly Installment*
S404I-0—Lovely bungalow. ." rooms
and bath and other up-to-date
feature*. This la a beautiful
place and a real bargain.
fci.-UMh—Se«en room residence lo-:
cated In the beat section of
Palo Alto. There la m roomy j
lot with nice lawn, fruit and-
flower*. Kasy terms.
For Rent—Housekeeping
none betUr In Palo Alto. Reasonable. 4M Hamilton avenns,
io-u-ti
Cl&siifled AdTertisements
WANTED.
PROFESSIONAL
ATTORNEYS
NORMAN t HALCOUI
AllUBMU AT LAW
HOTART PtlBUC
First National Bank baOdlag.
Palo Alto
NOTARY PUBLIC.
DICY A. BAUOHJ
Notary Public
257 University Ave.
SCHOOLS.
Otto Schocn. upholsterer. R20
High street, desires work st cas*
tomer'* houae. 10-2'-*Sta
Wanted — Barn to reat as
garage: also one famished room
In boase. Pbone 15. 10-22-lt*
Table board at CSI Waverley at.
10-tS-lw**
MRS. DWIGHT V. ROSS
Teacher of Piano.
Stu.li.. 690 AddleoB Aveaasv
E, ROYAL PLINT
A, B. Btanford 1901
Lelpslc Conservatory Diploma
PIANO AND HARMONY
Htwdlo MO Homer Aveawe
For R-kSt— AttrartlTe eloee-In
house of eight rooms and convenience* Can be used ss two four-
room flsta. Rent. 15, unfurnished,
or tl** for *lngle fist. Handy location, nice house. Enquire 173 Lytton avenue, t-20-tf
For Rent—Kaceptloaally comfortable room, morning ann, reasonable: gentleman or lady: half
block from streetcar. 242 Homer.
10-20-tf
mnna -in-.-i
rlaeo to via
biime on Waverley atreet ; •**>n*-ia*ly ami briefly what be wanted
• • ■ j to aay tt> ber. and I wrote Ibe frlii*
Mrs * P Knlierin nf llli Ra-' ""° •,l,*",■ "• '""P1**"! the tetter* him
•^ •**|f. blunhliiB fre*iuently a* be n*ud
1 *oa* *" SMn Pn*m\ what I had ad,le*l In tbe way fit SSOtl
her mother. ««.;,„,..,( That young lady re.*elt-d *..ui.-
Rtitierta has been In poor health re-1 of the m-wt wonderful lov* letter* ever
cently. wrlitpu This) wt*r« married durlne
• • • th« winter"
<; l^ltnv Stevirk and family. «hn — "
have heen living al the cornri .,f, Bangal and Ita Languag*.
Hale *treel and Inlversltv uwh.1 The i*e..ple ..f IteiiBnl uunilHT bs* "
OUT OF TOWN
•MOB—Ten acre* near Sunnyvale..
Alfalfa and fruit: fair buildings,
and plenty of water. Will]
trad* for Palo Altn residence!
aa part payment
• IM.iKMl—Ten acre* near Sunnyvale.!
highly Impr-ivi-d beat of bulM-
Ings and equipment, one of thei
great Income place* of tbe Tai*!
ley, It'a worth tbe WRMM
and the one wbo buy* It Islal
luck.
For
Rent—Business property. Id-
quire
431 High street 10-1-lm
For
Rent—Sunny furnlahed front
room.
privilege light housekeeping
Phone
P. A. 929. I'i', Emerson.
lt-lS-tw*
gjf.2.10—Five aire-* near Sunnyvale,
fair buildings: bare land but
l-eal of fruit coll; trees 'for
planting Imluded. it Is the fane
beet bargain for Its size In this
aectlon. Speak quick or the
other fellow geta It.
If you want well-furnlabed sunny
rooms, in a eholca location, heated
by furnace and with free baths and
use of large parlor and piano, come
to "The Palm*1' at -wiener or Bryant
•tree*, and l.ytton avenue Terms
reasonable. Mrs. E M. Grant, prop.
lo-n-m*
FOR SALE.
Wanted—Day's wort. Can serve
dinner*, parties, etc. pbone Mr*
Tate. S4SL. >-2S-tf
Gardening or aay kind of work.
Would Ilk* few places to care for. <
Steady. **:.: Channing. I07K evening
9-16-1m
Wanted—Laundry to take home
Phone '.'*•!. 10-U-tf
Wanted—Girl to attend ofllce
and answer telephone 919 Alma
atreet. Phoae 11«. 10-23-3t* 1
Wanted—Position on ranch by
practical experienced farmer: understand* care of stock: will take full
charge. References. Box A. Times. (
10-H-lw**
Wanted—Position as caretaker,
Janitor or handyman. Can do most
anything. C. Cfarlstenson. Menlo
Park. lO-Sl'tw*
Wanted—fresh mllkeow. Addrea* j
narker's Paragon dairy. 19-M-lw*
Fraulein Hclcnc Don)
Grwdwaie LeSpsfc ("owaerratorr
VOIOC. PIANO. ('KRMAM
1*4.1. Waverley Si. PhOM S74
PRIVATE TUTOR
JOHN A. SQUIRE, A. B.
Latin, Greek, Meteorology
P. O. Box 5. Telephone 58
FLORENCE RUFFNER
Practitioner and teacher of
"The New Thought."
Realdence 625 Emerson st.
MISCELLANEOUS.
Wanted—Good second-hand man'*"- ■
bicycle. 429 Homer ave. 10*22-1W*\ M^,' RoM ,,h ,B »*t«nt for Rem-
. lenknll hosiery, formerly sold by
2.000 on Mrs. Pennebaker Phone 75«K.
10-U-lm
For sale House and
"""10 Emerson street.
nvenue.
Ihe Alden hfrtin*-
road.
Embareader-j ,lim.
I ty utlll'i'tir*. and (xni-t of perbap* the
0 1—• . ulturr hi India at tbe pn-»*iit
Tbt- Iniicuai-e aa a writteu Inn
[giiaga in only nfiy -rtMra uid Thoogb
• • " f.»r uvrr a thoinuiud yuars It baa l*«-ii
Ray Brojns, who bai heen playing ■ "Hilecl- «b**r^ U lu Indian blatory
full «n the Stanford vanity thi*., 'mf-'Huii-iti-iy *>•> tr*.*e of I U-turn 11 hsv
fall. Is oul ol the game for the v-t»r!,,": *** **** *''MH*rtaui literary to..,;-...
WANTED-
vialon
1(0 acrea for
r Hi^idl-
«»n account uf injurlen received three
-••''i> kgn Rr«»n wa* hurt
sorerml »e».k*. ago. and he
game lant Sattir
have advlned hln
year
ard time m the
ay The *li-nor*.
- Ip r«n Uiii
Gu*f t* Miller, n trustee of the
Palo Alto public library-* left today
tm Santa Crui lo attend the quartern meeting ol the second district
California Librarj •us.wiatinn which
ineei-. today und tomorr«w M*
Miller i« ].**->,idt-iit of the asuocia-
tum und pbstts to ham the
!n*-*-ilng held here In February
at the presen
The liiiiguu*;« originates from Sanskrit. Ibe mother tongue fnun wlil. h
<*g»ln ,tvrri other Indian latiguaee ba* l-or
had 1 :■:.*.A iu alphabet, aramiuar and vo
cahnlatf: hut. unllks -Jtiu-r-*. itenuaii
never *-brlnk* from gatberiug new ma
teriala There aee numerou* I'eralmi
French. Aratnc and Fugllah wonln In
corjHinit.-al 111 It. and Ibe wopdi-r ot II
Is thai. Iiiite-id of linviiur in-t-ii de
graded hstfl *-ioie vulgar form like pld
gin Klu-ll*.'!. BeOESlI haa (k-coiiii- the
most Hlernry. wrleatlfle and |.erhii|i->
ti..* tno-n pfallnmipble of ntodsra Indian
lancua g«**- *%\\ rtimaiii
SOLITUDE.
In tbe dark niiriiL
Thine eye*.
In the atlll rimin.
Thy rot***;
In aolltude.
Thy prew-m-e nnd thy touch
But when the daylight come*
And drt-arua are flnwn
It Is the world surrounds me.
Then—I am alone
-Author t'nkn.-wn
>t Apply
9-2€-tf
For Sale—High-grade Jsrssy
heifer one year old. 1431 Waverley
10-7-tf
Ten-room modern residence for
•ale or exchange. Price 910.000;
liberal teritt-i Write for circular or
call C>. R. Slocum. cur. Lytton-Alma
10-U-lm
Wanted A loan of
good improved property. John F
Ilysbee. 1*91 Lytton ave.. Palo Alto, j
10-22-lw
For Sal*—Heating etov* almo«t
new. £30 Lytton Phone *.08X.
10-23-tf '
For Sale—Good reliable horse.
cheap Call *53j Homer avenue.
10-23-tw**
Fashionable dreasmaklng. lira.
Miller, :■•*•* Addlaon ave 10-4-lm*
BEST CARPET (LEANING.
Hraaor A Co. Phone 7<"* 10-3-tf
EXCHANGES.
Fur Sale -TIRE VULCANI7.ERS.
A good thing. Btl Hlgb street
Residence phone *5««X. 9-23-tf
, For Sale—PALO ALTO INVEST-
i MENT CO stoek. ten ahare*. par
value 31.000. Will give time on
; payment Make offer Write El-
, bert E. Peck, owner. 431 Van Nuys
1 Hulldlng. Lo* Angele* 10-21-St
Make offer In trade for all or
part of 7n-aere waterfront; TiO acre*
level. One land, timber, bunting.
fishing: near good town in Coos
couniy. Oregon: 1,900 clear Write
C J Christiansen. 44« Hamilton
avenue. Palo Alto. l»-"*l-3t*
Edith M. Daren, I" M , gradual*
Conservatory of Pacific. S, J., teacher of piano. 324.Emerson. Ph. 7">7X
10-l-lm*
I can save you money on Insurance I'hone .'.!**•!, or drop me a
card. A N. t'mphreys. 9*3-ltn
Money to loan on real estate •*-
eurlty. Rodger* A Smith, attorneys
at law. Madlaoo-Tholu bulldlog.
Palo Alto. Cal. ..«-■-
LOST
PALO ALTO VACl-TJ!
CARPET CLEANING
FOR SALE.
-:•
The Well* at the Stanford puntp-
nagt ing .ilant ou the county road nre
The -celling ■"** ■ '■*■■■ tl* supply the uni
aes- verslty with water tbe pOSttps are
Foi
largely with tin
d the nun
f h
usteee'
■ok*.
kept
thi
nnlng alt day aud part of
night.
Sale Range. Monar.li
used only few m "k^''*%iI0*B II
A PROFITABLE
PLAN
for the person who desires to save i* io take Installment
stuck tn tbi. At-eoctatlon.
Organised and managed by home [leoiilp,
1 ndi*r tin- supervision of the state Authorities.
Strong and safe.
Our -tuck earned 7 per cent last year. At maturity vou
receive the full amount raid in »iih nit earnings one do!-
tnr per share per month.
-ft eirenlar explaining our system for lhe a-klng CS
particular*.
Palo Alto Mutual Building and
Loan Association
<'. 11. cii.iikrt. Pradam. A1.KUKH skai.k. eeteeteti.
APPLES
At the Package Store
No. a Smith Cider Apples, box 85c.
No. a White Winter Pearmain. box 1.10.
No. 1 Fancy Pearmains, box $1.65.
BIG YELLOW PUMPKINS FOR HALLOWEEN
COME EARLY AND AVOID THE RUSH
Call up 350K
The Package Store
E. W. COOKE Proprietor
Earle -& Co.
The House of
Quality
Progress
and
Accommodation
Not until oui goods enter your homes
do we relinquish our careful supervision
over ihem, in order that they may reach
you in the best condition
Masonic Temple Building
. hones 837 and 838
-J
Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study
No full textThe identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912–7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990). Graphical abstract: [Figure not available: see fulltext.]
coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit
No full textBackground/objectives: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. Methods: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. Results: Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P < 0.00001), early enteral feeding (33.2%, χ2 11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ2 354.64, P < 0.00001), with wide variability based on the admitting speciality. Conclusions: The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990)
coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit
No full textBackground/objectives: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. Methods: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. Results: Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P &lt; 0.00001), early enteral feeding (33.2%, χ2 11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ2 354.64, P &lt; 0.00001), with wide variability based on the admitting speciality. Conclusions: The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990). © 2022 IAP and EP
